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Title: Analysis of Prognostic Factors After Yttrium-90 Radioembolization of Advanced Hepatocellular Carcinoma

Purpose: To analyze which patient-, tumor-, and treatment-related factors may influence outcome after {sup 90}Y radioembolization ({sup 90}Y-RE) for hepatocellular carcinoma (HCC). Patients and Methods: Seventy-two consecutive patients with advanced HCC treated with {sup 90}Y-RE were studied to detect which factors may have influenced response to treatment and survival. Results: Median overall survival was 13 months (95% confidence interval, 9.6-16.3 months). In univariate analysis, survival was significantly better in patients with one to five lesions (19 vs. 8 months, p = 0.001) and in patients with alpha-fetoprotein <52 UI/mL (24 vs. 11 months, p = 0.002). The variation in target tumor size and the appearance of new lesions were analyzed among 50 patients with measurable tumors. A decrease in target tumor size was observed in most patients, and the intensity of such decrease was not associated with any of the factors under study. Patients who developed new lesions in the treated liver (and also in the nontargeted liver) at month 3 more frequently had more than five nodules, bilobar disease, and alpha-fetoprotein >52 UI/mL, and their survival in the multivariate analysis was significantly worse (hazard ratio, 4.7; 95% confidence interval, 13-1.73) (p = 0.002). Conclusions: Yttrium-90 radioembolization results in controlmore » of target lesions in the majority of patients with HCC but does not prevent the development of new lesions. Survival of patients treated with {sup 90}Y-RE seems to depend largely on factors related to the aggressiveness of the disease (number of nodules, levels of alpha-fetoprotein, and presence of microscopic disease).« less
Authors:
 [1] ;  [2] ;  [3] ;  [2]
  1. Liver Unit, Department of Internal Medicine, Clinica Universitaria de Navarrra, Pamplona (Spain)
  2. Department of Interventional Radiology, Clinica Universitaria de Navarrra, Pamplona (Spain)
  3. Department of Nuclear Medicine, Clinica Universitaria de Navarrra, Pamplona (Spain)
Publication Date:
OSTI Identifier:
21451145
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 77; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.07.006; PII: S0360-3016(09)01033-5; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; EMBOLI; FORECASTING; HEPATOMAS; SURVIVAL CURVES; YTTRIUM 90 BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; CARCINOMAS; DAYS LIVING RADIOISOTOPES; DISEASES; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NEOPLASMS; NUCLEI; ODD-ODD NUCLEI; RADIOISOTOPES; YTTRIUM ISOTOPES